| Creekside Family Dental Pc | |
|
620 12th St Se Salem OR 97301-4001 | |
| (503) 581-2454 | |
| (503) 581-1819 |
| Full Name | Creekside Family Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 620 12th St Se, Salem, Oregon |
| Authorized Official Name and Position | Bryan Nakagawa (PRESIDENT) |
| Authorized Official Contact | 5035812454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Family Dental Pc 620 12th St Se Salem OR 97301-4001 Ph: (503) 581-2454 | Creekside Family Dental Pc 620 12th St Se Salem OR 97301-4001 Ph: (503) 581-2454 |
| NPI Number | 1659408276 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659408276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7934 (Oregon) | Primary |
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